热量限制防治肾脏纤维化的作用机制

The mechanism of caloric restriction in the prevention and treatment of renal fibrosis

肾脏纤维化是慢性肾脏病(chronic kidney disease,CKD)进展过程中共同的病理改变,其特征是间质间隙的细胞外基质(extracellular matrix,ECM)过度沉积,这是CKD最突出的标志。既往研究证实,肾纤维化与线粒体、炎症、脂质代谢及自噬有紧密联系。热量限制能通过改善线粒体功能、抑制炎症因子分泌、减少脂质生成、增加脂质分解和增强自噬来减缓肾脏纤维化进程。鉴于肾脏纤维化的潜在患病率和不良预后,目前在临床上对肾脏纤维化的治疗手段相当有限,了解肾脏纤维化的机制和延缓肾脏纤维化的进展具有重要的临床意义。本文就热量限制在肾脏纤维化中的作用原理及研究现状进行综述,以期为临床治疗提供理论指导。

Renal fibrosis is a common pathological change in the progression of chronic kidney disease(CKD),which is characterized by excessive deposition of extracellular matrix(ECM)in the interstitial space,which is the most prominent sign of CKD.Previous studies have confirmed that renal fibrosis is closely related to mitochondria,inflammation,lipid metabolism and autophagy.Caloric restriction can slow down the process of renal fibrosis by improving mitochondrial function,inhibiting the secretion of inflammatory factors,reducing lipid production,increasing lipid decomposition and enhancing autophagy.In view of the potential prevalence and poor prognosis of renal fibrosis,the current clinical treatment of renal fibrosis is quite limited,understanding the mechanism of renal fibrosis and delaying the progression of renal fibrosis is of great clinical significance.This work reviewed the principle and research status of caloric restriction in renal fibrosis,in order to provide guidance for clinical treatment.